A History of Radiation in Skin Cancer Treatment

I am a radiation therapist working in a dermatology office treating non-melanoma skin cancers with superficial radiation therapy. This statement no longer even seems unique to me. For many patients, it is a whole world, completely unknown. So let's go through the history of radiation in skin cancer treatment.

The history of radiation in skin cancer treatment

Quite frequently, I get one question that definitely requires me to break out the history books: “How long has radiation been used to treat skin cancers?” It turns out to be a great question and not one you can easily ask Alexa. So let's dive into it.

Why is this so hard?

So why is it so hard to find a history of radiation therapy in the treatment of skin cancers? Is it because this treatment is just too new? No, just because surgery is the most commonly known treatment for the removal of skin cancers does not mean that radiation therapy is a brand-new discovery.

So when was it discovered?

Radiation was discovered in 1895 by William Rontgen, and within a few years, scientists understood the properties of radiation just enough for it to become a new cancer treatment. The first patient treated with radiation was a rodent with a basal cell carcinoma that was successfully treated in Sweden.¹

It actually didn't go so well at first

But let’s be honest, radiation’s debut as a new type of treatment did not go very well. The first patients and scientists who worked with radiation experienced many adverse side effects. Scientists would use their own bodies to learn about the effects of treatment, allowing them to study erythema or the reddening of the skin. Their careless exposure to radiation caused many scientists to develop cancers, leukemia, and other blood diseases.² It would take another 20 years of research and understanding before radiation was used safely.

The more you know...

As the understanding of radiation as a therapy grew, different types of radiation were harnessed for different uses. Skin cancers were treated with radioactive sources in contact with the skin or with machines that created a radiation treatment only powerful enough to penetrate to a certain depth in the body. These treatments turned out to be successful in eliminating cancers.

Performing the treatment was actually hard

The issue was not with the cure rates; it was with performing the treatment itself. The radioactive materials and equipment required for treatment are dangerous and require trained and licensed professionals, but they are also expensive to acquire and maintain with strict regulations. If that weren’t enough to deter doctors from using it in their practice, the reimbursement amounts would definitely discourage them.

It wasn't worth the money

In the 1970s, doctors were trained in Mohs Micrographic Surgery, and with high reimbursement rates, radiation therapy faded away. Radiation continued to have a role in treating cancers deep within the body, but the doctors offering radiation therapy were scarce as for skin cancer.

Things have changed recently

The use of radiation therapy has started to make a comeback. As technology has advanced, so has the delivery of radiation. Companies have created superficial radiation machines that make it practical for an average dermatology office to have this technology. Companies, like Sensus Healthcare, not only supply the superficial radiation therapy unit, but they aid in training the staff and getting them certified as required by their state. Offices are now able to offer the treatment within their practice, and of course, are being reimbursed by major insurances and Medicare at rates that make the investment worthwhile.

Radiation therapy is a great option for some

Superficial radiation units, like the SRT-100, are not only FDA-approved, but they have a cure rate equal to that of Mohs surgery. These machines are continuing to advance, as some units offer ultrasound technology. The ultrasound imaging is performed periodically throughout the treatment course to monitor the lesion and help adjust the treatment based on the individual's response.

In the last 120 years, radiation has overcome obstacles and advanced into a very well-understood and safe treatment option. The use of radiation for treating non-melanoma skin cancers is on the rise, and superficial radiation therapy units are becoming more accessible worldwide.